Last Updated: September 2026
One of the most confusing parts of Medi-Cal is knowing who to call when something goes wrong.
You may call your county and be told to contact your health plan. Then you call your health plan and are told to contact Medi-Cal Health Care Options.
Or you may spend a long time explaining your problem only to discover that you contacted the wrong organization.
County, Health Plan, Health Care Options, DHCS Helpline, or Ombudsman — who actually handles your Medi-Cal problem?
The answer depends on what part of Medi-Cal your problem involves.
The easiest way to understand it is to separate Medi-Cal problems into several categories:
- Eligibility and your Medi-Cal case
- Your managed care health plan
- Health plan selection or enrollment
- Doctors, PCPs, referrals, networks, and medical services
- Complaints and unresolved managed care problems
- Formal eligibility or benefit disputes
Once you identify which category your problem belongs to, it becomes much easier to know where to start.
Quick Answer: Who Should You Call?
| Your Problem | Where to Start |
|---|---|
| Application, eligibility, renewal, income, address, or case status | County Medi-Cal Office |
| Choose or change a Medi-Cal managed care health plan | Medi-Cal Health Care Options |
| Doctor, PCP, referral, authorization, network, or plan-specific service | Your Medi-Cal Health Plan |
| Find a doctor who accepts your Medi-Cal plan | Your Health Plan / Provider Directory |
| General Medi-Cal or certain billing questions | DHCS Medi-Cal Helpline |
| Managed care problem that remains unresolved | DHCS Ombudsman |
| Disagreement with certain Medi-Cal eligibility or benefit actions | County and/or State Fair Hearing |
1. Call Your County for Medi-Cal Eligibility and Case Problems
Your county Medi-Cal office is usually the place to start when the problem involves your Medi-Cal eligibility or case.
Contact your county for questions such as:
- Is my Medi-Cal active?
- What happened to my application?
- Was my renewal processed?
- Why was my Medi-Cal discontinued?
- Did the county receive my documents?
- How do I report an income change?
- How do I update my address?
- Why did my eligibility change?
- What is my Share of Cost?
- What happens if I move to another county?
If your question is mainly “Do I have Medi-Cal, and what is happening with my Medi-Cal case?”, start with your county.
If you recently submitted a renewal, income information, or other documents, ask whether the county actually received and processed them rather than simply asking whether your Medi-Cal is active.
2. Call Health Care Options to Choose or Change a Health Plan
Medi-Cal Health Care Options, often called HCO, helps members with managed care health plan choices and enrollment.
Contact Health Care Options for questions such as:
- Which Medi-Cal health plans are available where I live?
- Which health plan am I currently enrolled in?
- How do I choose a Medi-Cal health plan?
- How do I change my health plan?
- What happened to my plan change request?
- When will my new plan become effective?
Medi-Cal Health Care Options
Phone: 1-800-430-4263
TTY: 1-800-430-7077
Monday–Friday, 8 a.m.–6 p.m.
3. Call Your Health Plan for Doctors, PCPs, Referrals, and Medical Services
Once you are enrolled in a Medi-Cal managed care health plan, many questions about actually receiving medical care should start with your health plan.
The Member Services phone number is usually printed on your health plan member ID card.
Contact your health plan for questions such as:
- Who is my Primary Care Provider (PCP)?
- Can I change my PCP?
- Does this doctor accept my plan?
- Is this doctor in my network?
- How can I find a specialist?
- Do I need a referral?
- Why was an authorization denied or delayed?
- Why am I having trouble getting an appointment?
- Why did my plan deny or change a service?
- How do I file a grievance?
- I did not receive my health plan member ID card.
Need help finding a doctor?
A doctor may say that the office “accepts Medi-Cal,” but that does not automatically mean the doctor participates in your specific Medi-Cal managed care plan.
Always confirm your specific plan and network before scheduling when possible.
Health Care Options and Your Health Plan Are Not the Same Thing
Health Care Options
Helps you choose or change a Medi-Cal managed care health plan.
Your Health Plan
Helps you use your coverage after enrollment — including doctors, PCPs, referrals, authorizations, services, and grievances.
4. What If Medi-Cal Is Active but the Doctor Says It Is Inactive?
This situation can be especially confusing because “inactive” does not always mean that your underlying Medi-Cal eligibility has ended.
The issue could involve:
- Medi-Cal eligibility
- Your health plan enrollment
- The effective date of your health plan
- The provider’s network participation
- Your PCP assignment
- Incorrect member information
If your county confirms that your Medi-Cal eligibility is active, ask the provider exactly what is showing as inactive.
“What exactly is showing as inactive — my Medi-Cal eligibility, my health plan enrollment, or my coverage with this provider?”
Read the complete troubleshooting guide:
→ My Medi-Cal Is Active, but the Doctor Says It’s Inactive — What Should I Do?
5. Call the DHCS Medi-Cal Helpline for General Medi-Cal Questions
The DHCS Medi-Cal Helpline provides general Medi-Cal information and can assist with certain Medi-Cal and billing questions.
DHCS Medi-Cal Helpline
Phone: 1-800-541-5555
Monday–Friday, 8 a.m.–5 p.m.
However, the Helpline does not replace your county or your managed care health plan.
If your problem is clearly about eligibility, start with your county. If it concerns services under your managed care plan, start with your health plan.
6. Contact the Ombudsman for an Unresolved Managed Care Problem
If you have a Medi-Cal managed care problem and your normal attempts to resolve it are not working, the DHCS Ombudsman may be another resource.
Before contacting the Ombudsman, keep notes about:
- Who you contacted
- When you contacted them
- What the problem was
- What you were told
- Any reference or case numbers
- What steps you already took
DHCS Medi-Cal Managed Care and Mental Health Office of the Ombudsman
Phone: 1-888-452-8609
TTY: 711
Monday–Friday, 8 a.m.–5 p.m.
7. What If You Want to File a Complaint About Your Health Plan?
If you are unhappy with your Medi-Cal managed care health plan, contact the plan’s Member Services department and ask about its grievance process.
Depending on the issue and circumstances, additional options may include:
- Filing a grievance with the health plan
- Appealing certain decisions
- Contacting the DHCS Ombudsman
- Changing your health plan when permitted
- Using State Fair Hearing rights when applicable
Keep copies of notices, appeal documents, letters, and any confirmation or reference numbers you receive.
8. When Might a State Fair Hearing Be Appropriate?
A State Fair Hearing is different from simply calling customer service.
It is a formal process that may be available when you disagree with certain Medi-Cal eligibility, benefit, service, or government actions.
Examples may include:
- You disagree with an eligibility decision.
- Your Medi-Cal was discontinued and you believe the decision is incorrect.
- Your Share of Cost changed and you disagree with the decision.
- You received a Notice of Action that you believe is incorrect.
- Another Medi-Cal eligibility or benefit issue involves hearing rights.
Real-Life Examples: Who Should You Call?
Example 1: “I submitted my renewal, but my Medi-Cal ended.”
Start with: County Medi-Cal Office
This is primarily an eligibility and case-processing issue.
Example 2: “I want to change to another Medi-Cal health plan.”
Start with: Medi-Cal Health Care Options
Example 3: “My doctor says they accept Medi-Cal but not my plan.”
Start with: Your Medi-Cal Health Plan
Ask whether the doctor is in your network and request help finding another participating provider if necessary.
→ Learn how to find a doctor who accepts Medi-Cal
Example 4: “The wrong PCP is listed on my health plan card.”
Start with: Your Medi-Cal Health Plan
Example 5: “I requested a health plan change. When will it start?”
Start with: Medi-Cal Health Care Options
Ask which plan is currently active and the effective date of your requested new plan.
Example 6: “The county says Medi-Cal is active, but the doctor says inactive.”
First identify whether the problem involves eligibility, plan enrollment, the effective date, or the provider network.
→ Read the full Active vs. Inactive Medi-Cal troubleshooting guide
Example 7: “My health plan keeps sending me back and forth.”
Document your attempts to resolve the issue. If it remains an unresolved managed care problem, the DHCS Ombudsman may be an appropriate next resource.
Special Situations: Pregnancy and Newborn Medi-Cal
Pregnancy and newborn coverage can involve additional Medi-Cal rules.
Pregnancy Coverage
→ Pregnancy Medi-Cal (MCAP)
Newborn Coverage
→ Newborn Baby Medi-Cal: How to Get Free Health Coverage for Your Baby (2026)
Before You Call: Use This 5-Minute Checklist
✓ 1. Describe your problem in one sentence.
Example: “I submitted my renewal, but my Medi-Cal now shows inactive.”
✓ 2. Decide whether the issue is eligibility, plan enrollment, or using your health plan.
✓ 3. Have your Medi-Cal BIC and health plan card ready.
✓ 4. Have important notices, dates, and reference numbers available.
✓ 5. Write down what each office tells you.
What to Say When You Keep Getting Sent to Another Office
You can say:
“I want to make sure I contact the correct office. Is this an eligibility issue, a health plan enrollment issue, or a health plan service issue?”
“If your office does not handle this, can you tell me specifically which organization does?”
“What should I tell the next office so they understand what has already been checked?”
The Easiest Way to Remember
COUNTY = Do I have Medi-Cal?
HEALTH CARE OPTIONS = Which Medi-Cal health plan am I joining or changing to?
HEALTH PLAN = How do I use my coverage for doctors, referrals, authorizations, and medical services?
Related Medi-Cal Guides
Medi-Cal Shows Active but Doctor Says Inactive
→ My Medi-Cal Is Active, but the Doctor Says It’s Inactive
Finding a Medi-Cal Doctor
→ How Can I Find a Doctor Who Accepts Medi-Cal?
Pregnancy Coverage
→ Pregnancy Medi-Cal (MCAP)
Newborn Coverage
→ Newborn Baby Medi-Cal Guide
Final Takeaway
When you have a Medi-Cal problem, simply calling “Medi-Cal” is not always enough because different organizations handle different parts of your coverage.
Is this an eligibility problem, a health plan enrollment problem, or a problem using my current health plan?
If it is about your eligibility or case, start with your County.
If it is about choosing or changing a managed care health plan, start with Health Care Options.
If it is about doctors, PCPs, referrals, authorizations, networks, or services, start with your current Health Plan.
If an ongoing managed care problem cannot be resolved through the usual channels, the DHCS Ombudsman may be another resource.